Neoadjuvant therapy

Neoadjuvant therapy helps shrink the tumor(s) in the breast and lymph nodes so surgery can better remove all of the cancer.

Most women get neoadjuvant chemotherapy, usually with an anthracycline-based chemotherapy and a taxane-based chemotherapy [9].

All the chemotherapy planned to treat locally advanced breast cancer is usually given before surgery [9].

If the tumor does not get smaller with the first combination of chemotherapy drugs, other combinations can be tried.

If the tumor is HER2-positive, neoadjuvant trastuzumab (Herceptin) may be given, but not at the same time as an anthracycline-based chemotherapy [9]. Neoadjuvant pertuzumab (Perjeta) may be given in combination with neoadjuvant trastuzumab [9].

Some postmenopausal women with hormone receptor-positive tumors may get neoadjuvant hormone therapy (usually with an aromatase inhibitor) [9].

In some cases, if the tumor does not respond to neoadjuvant therapy, radiation therapy may be given before surgery [9].

Neoadjuvant therapy

Neoadjuvant chemotherapy helps shrink the tumor(s) in the breast and lymph nodes so surgery can better remove all of the cancer.

When possible, all the chemotherapy planned to treat IBC is given before surgery [9].

If the tumor does not get smaller with the first combination of chemotherapy drugs, other combinations can be tried.

If the tumor is HER2-positive, neoadjuvant trastuzumab (Herceptin) may also be given, but not at the same time as the anthracycline-based chemotherapy [9]. Neoadjuvant pertuzumab (Perjeta) may be given in combination with neoadjuvant trastuzumab [9].

In some cases, if the tumor does not respond to neoadjuvant chemotherapy, radiation therapy may be given before surgery [9].

You can download and print out these cards and take them with you to your next doctor appointment. There’s plenty of space to write down the answers to these questions, which you can refer back to later.

Talk with your health care providers about which treatment guidelines they use. Since there’s often a lag time between the latest research and guideline updates, most providers prefer to base their treatment on the latest research.

Playing an active role

You can play an active role in making treatment decisions by understanding your breast cancer diagnosis, your treatment options and possible side effects you may have.

Together, you and your health care provider can choose treatments that fit your values and lifestyle.

In 2013, the Health and Medicine Division of the National Academy of Sciences (formerly the Institutes of Medicine) released a set of recommendations (below) on improving cancer care in the U.S. The report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis recommended improvements to fix shortcomings that add cost and burden to cancer care. Susan G. Komen® was one of 13 organizations that sponsored this study.

The report identified key ways to improve quality of care:

Ensure cancer patients are engaged and understand their diagnoses so they can make informed treatment decisions with their health care providers

Develop a trained and coordinated workforce of cancer professionals

Focus on evidence-based care, using information technology to provide better information about the potential benefits of treatments